Gastric Diseases Flashcards
why do you need to check bowel sounds in suspected gastric disease?
you need to check for perforations, which are an emergency
Why do NSAIDs cause GI injury?
they inhibit prostaglandins thru reversible inhibition of both COX-1 and COX-2 enzymes
prostaglandins are key in GI mucosal protection
What patients taking NSAIDs are more likely to get ulcers?
hx of ulcer or GI complications
increasing age
anticoagulant use
corticosteriod use
high doses of NSAIDs
What’s H. Pylori?
Gram negative rod
that infects stomach or duodenum and leads to inflammation
produces urease with reacts with urea to form NH4
(Carcinogen!)
Who is at risk for H. Pylori infection?
Low socioeconimic status
elderly
minority groups
immigrant populations
How do we test for H. Pylori?
gastric biopsy
urea breath test
stool antigen
serology
what’s the treatment for H. Pylori?
antibiotics for two weeks and proton pump inhibitor
Anerobe - flagyl
when do you use clips vs. cautery for ulcer repair?
clips are for smaller ulcers
cautery for larger
what percentage of duodenal and gastric ulcers are healed by PPIs and in what time frame?
duodenal - 90% at 4 weeks
gastric - 90% at 8 weeks
(when given once daily 30 minutes before breakfast)
what is MEN 1 syndrome?
tumors of pancreas
tumors of duodenum
what are the most common causes of erosive gastritis
Medications (NSAIDs)
Alcohol
Stress
Portal hypertension
Ischemia
Caustic ingestion
Radiation
What are the most common causes of non-erosive gastritis?
H. pylori 30-50% has chronic gastritis
pernicious anemia
eosinophilic gastritis
what is gastroparesis?
reduced or decreased motility of the stomach
what are the symptoms of gastroparesis?
bloating
nausea/vomiting
early satiety
epigastric pain
regurgitation
weight loss
what’s a bezoar?
a hunk of undigested food just sitting in the stomach
